Self-perceived Physical Health Research Articles

The association between perceived interpersonal social support and physical and mental health: results from the national epidemiological survey on alcohol and related conditions

Low social support has been associated with several disorders. We test the relationship between perceived interpersonal social support (ISS) and aspects of mental and physical health. We used data from National Epidemiological Survey on Alcohol and Related Conditions in which 34,653 individuals aged 20-99 years were interviewed twice (2001-02 and 2004-05), with the second interview including the interpersonal support evaluation list. The association of perceived ISS with lifetime DSM-IV psychopathology and physical health from the past 12 months was investigated. We also tested whether this association changes as a function of number of traumatic events in accordance with the buffering hypothesis. Low perceived ISS correlated with increased prevalence of major depressive disorder, generalized anxiety, social phobia and several physical health problems. There was a strong association between excellent self-perceived physical health and high social support. There was evidence for both the main, beneficial effects of high perceived ISS and buffering, whereby increased perceived ISS ameliorated the pathogenic influence of exposure to traumatic life events on psychopathology. Current findings highlight the importance of perceived ISS in individuals' general mental and physical well-being, both in daily life and upon exposure to negative life events.

Most very low birth weight subjects do well as adults

To study health, quality of life, educational level and occupation in very low birth weight (VLBW) children in early adulthood and the relationship of the findings to neonatal risk factors and later handicap. This is a prospective long-term follow-up study of a regional cohort of 20-year-old VLBW subjects (n = 77) of all surviving VLBW children (n = 86) and 69/86 term controls born in 1987-1988 in the south-east of Sweden. Postal questionnaires were used: 1. A study-specific form, 2. Medical Outcomes Study, Short Form (SF-36), 3. Sense of Coherence. VLBW subjects did not differ significantly from their controls in self-perceived health, use of tobacco, education, occupation and way of living, or scoring on SF-36 and Sense of Coherence. Sixteen had cerebral palsy, attention deficit hyperactivity disorder or isolated mental retardation, and these subjects differed significantly from controls on SF-36 in physical functioning and physical health score, but not on Sense of Coherence. VLBW subjects were significantly lighter and shorter than their controls. Extremely low birth weight (ELBW), bronchopulmonary dysplasia and intraventricular haemorrhage were significantly associated with poorer scores on physical function. The 20-year old VLBW subjects reported perceived health and managed transition to adulthood similar to controls. Handicapped subjects had poorer self-perceived physical function. ELBW and severe neonatal complications were associated with poorer self-perceived physical health.

Initial Outcomes of a Mental Illness Self-Management Program Based on Wellness Recovery Action Planning

Initial Outcomes of a Mental Illness Self-Management Program Based on Wellness Recovery Action Planning

Adherence to the Mediterranean diet is associated with better mental and physical health

The aim of the present study was to analyse the association between adherence to the Mediterranean diet and self-perceived mental and physical health function, controlled for confounding effects of age, smoking, BMI, alcohol consumption, educational level, leisure-time physical activity and the presence of chronic conditions. A random sample of the 35-74-year-old population (3910 men and 4285 women) of Gerona, Spain, was examined in 2000 and 2005 in two independent population-based cross-sectional surveys. Dietary intake was assessed using a validated FFQ. The Mediterranean diet score (MDS) was calculated according to tertile distribution of energy-adjusted food consumption considered characteristic for the Mediterranean region. Health-related quality of life was measured using the SF-12 questionnaire. Alcohol consumption, leisure-time physical activity and smoking habits were recorded. Weight and height were measured. Age-adjusted linear regression analysis revealed a significant (P < 0.01) direct association of the MDS with self-reported mental and physical health in both sexes. An increase of 5 units of the MDS was directly associated with changes of 0.74 and 1.15 units in men and women, respectively, in the mental component score after controlling for potential confounders. The age-adjusted direct association of the MDS with self-reported scoring of physical health remained stable after adjusting for several confounders in men but was attenuated in women. Adherence to the Mediterranean diet was associated with higher scoring for self-perceived health.

Children's delayed development and behavior problems: Impact on mothers' perceived physical health across early childhood

Mothers of children with developmental delays may experience poorer psychological well-being than other mothers; however, little research has examined how delayed development in children might predict mothers' perceived physical well-being. Children with delayed development manifest heightened behavior problems, which may negatively affect maternal well-being. We examined the associations between developmental delay and behavior problems at child age 3 and mothers' self-perceived physical health at child ages 3, 4, and 5, in families of 218 children with and without developmental delays. The study sample comprised 218 families from central Pennsylvania and Southern California, USA who were recruited through community agencies that provide diagnostic and intervention services for individuals with development difficulties. We found that mothers of children with delayed development at age 3 reported poorer concurrent and later physical health than mothers of children with typical development. Broadening the analyses to include not only child development status (delayed development versus typical development) but also child behavior problems at age 3, only child behavior problems and the interaction of development status and behavior problems, but not development status itself, predicted maternal health. Early child behavior problems contributed to later maternal health above and beyond early maternal health, suggesting a possible causal association between child behavior problems and mothers' physical health. The relation between child behavior problems and maternal health was moderated by mothers' parenting stress and mediated by depressive symptoms. Mothers of children with both delayed development and high behavior problems are a particular risk group that may be especially in need of early intervention. Further research should examine the behavioral and biological pathways by which these child-related stressors influence mothers' physical health.

Which factors determine our quality of life, health and ability? Results from a Danish population sample and the Copenhagen perinatal cohort.

To examine the statistical associations between Global Quality of Life (QOL) and a series of indicators representing health, ability, philosophy of life, sexuality, quality of working life and other medically relevant aspects of life. Cross-sectional comparative study using the self-administered SEQOL questionnaire. The Quality of Life Research Center, the University Hospital Copenhagen, Denmark. (1) A representative sample of 2,500 Danes (18-88 years) randomly selected from the CPR register, (2) Follow-up survey of members of the Copenhagen Perinatal Birth Cohort, 4,648 Danes (31-33 years). The associations were measured qualitatively as well as quantitatively calculating the difference in percentage and using the method of weight modified linear regression. QOL, measured by SEQOL (self-evaluation of quality of life), containing eight global QOL measures: well-being, life-satisfaction, happiness, fulfillment of needs, experience of temporal and spatial domains, expression of life's potentials and objective factors. Strongest was the association between QOL, overall view of life (41.5% / 59.1%), relationship to self (39.3% / 56.8%), partner (32.2% / 31.7%) and friends (33.3% / 42.7%). Different aspects of physical as well as psychological health were also strongly correlated with QOL: self-perceived physical health (33.2% /29.4%), satisfaction with own health (27.3% / 29.0%), self-perceived mental health (38.4/51.0), number of severe health problems (29.8% / 35.3%). Objective factors such as income, age, sex, weight and social group did not have any noteworthy relationship to QOL, and neither did lifestyle factors such as tobacco and alcohol consumption, drug use, exercise, and diet. It seems that the factors important for present QOL and health is derived from good relations, with the close as well as the distant world, and overall view of life. What one possesses in objective terms--money, status, work--does not seem to be important to global quality of life and of little importance to self-assessed health. Our results indicate that what is really important is not what one has, but how he sees, evaluates and experiences what he has. The person's level of consciousness and responsible attitude towards life and others seem far more important for the global quality of life and health.

Self-perceived physical functioning and health status among fully ambulatory multiple sclerosis patients

We investigated the self-perceived health status among multiple sclerosis (MS) patients with no or mild disability according to the Expanded Disability Status Scale (EDSS) and the impact of self-rated physical functioning. A sample of fully ambulatory (EDSS < or = 3.5) consecutive patients with MS was included after screening for major cognitive impairment. The EDSS was used to measure nervous system signs or disability, and the self-rated health status was assessed using the SF-36 Health Survey. The normative SF-36 data for the general population of Italy were used for comparison. The 197 MS patients analyzed (150 women and 47 men) had significantly lower mean SF-36 scores than the general population, except for bodily pain. The scores did not differ significantly by gender. The same analysis performed on a subsample of 105 patients (79 women and 26 men) with minimal disability in one functional system (EDSS < or = 2.0) yielded similar results. EDSS was weakly correlated with the physical functioning subscale and explained only 2% of the variance in the physical functioning subscale. The regression of the physical functioning subscale on the other seven SF-36 subscales was significantly lower among MS patients than in the general population for all subscales, except for role limitation due to physical health problems and social functioning. Neither disease course nor duration correlated significantly with SF-36 subscales. The SF-36 physical functioning subscale seemed to indicate physical functioning more sensitively than EDSS. These findings should encourage the implementation of specific strategies aimed at improving the quality of the self-perceived health status already in the early disease stage.

A Brief Risk Stratification Tool to Predict Functional Decline in Older Adults Discharged from Emergency Departments

To determine the effectiveness of the six-item Triage Risk Screening Tool (TRST) to assess baseline functional status and predict subsequent functional decline in older community-dwelling adults discharged home from the emergency department (ED). Secondary data analysis of a randomized, controlled trial. EDs of two urban academic hospitals. Six hundred fifty community-dwelling adults aged 65 and older presenting to the ED and discharged home. Patients were categorized a priori as "high risk" if they had cognitive impairment or two or more risk factors on the TRST. Functional status: summed activity of daily living (ADL) and instrumental activity of daily living (IADL) scores at baseline, 30 days, and 120 days. Self-perceived physical health: standardized physical health component of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Functional decline: loss of one or more ADLs and one or more IADLs from ED baseline at 30 and 120 days. Decline in self-perceived physical health: follow-up SF-36 standardized physical health component scores four or more points lower than baseline. TRST scores correlated with baseline ADL impairments, IADL impairments, and self-perceived physical health at all endpoints (P<.001). A TRST score of two or more was moderately predictive of decline in ADLs or IADLs (30-day ADL area under the receiver operating characteristic curve (AUC)=0.64; 95% confidence interval (CI)=0.56-0.72; 120-day ADL AUC=0.66; 95% CI=0.58-0.74) but not perceived physical health. The TRST identifies baseline functional impairment in older ED patients and is moderately predictive of subsequent functional decline after an initial ED visit. The TRST provides a valid proxy measure for assessing functional status in the ED and may be useful in identifying high-risk patients who would benefit from referrals for further evaluation or surveillance upon ED discharge.

Chernobyl Disaster Sequelae in Recent Immigrants to the United States from the former Soviet Union (FSU)

Long-term mental health sequelae of the 1986 Chernobyl disaster have been documented for exposed populations who remained in the former Soviet Union (FSU) (Havenaar et al., 1997), and in a cohort migrated to Israel (Cwikel et al., 1997). This paper reports on Chernobyl disaster sequelae in émigrés (n = 321) to the United States. Demographic characteristics, migration factors, and self-reported physical health were considered. Both geographical proximity to the 1986 disaster, and perception of radiation risk stood as long-term indicators of current psychological distress. Proximity was related to poor self-perceived physical health, as well as current symptoms of depression (p<.05), anxiety (p<.01), and Chernobyl-related trauma distress (p<.001) on standardized measures. Environmental contamination as a reason for migration was also associated with greater mental health symptomatology.

What predicts adherence to follow-up recommendations for abnormal Pap tests among older women?

To address socio-demographic factors associated with adherence to follow-up recommendations in a high-risk population of women referred for follow-up care after an abnormal Pap test. 486 women aged 46-64 served by BCCEDP in two southeastern states between 1999-2002 and referred for follow-up care after an abnormal Pap test were the sampling frame for this cross-sectional study; 204 women completed a phone-based interview in 2004. Cox proportional hazards modeling was used to determine the association of various risk factors with time to adherence. Among those completing the phone interview (interview rate=61.4%) the mean age was 53.3 years, 64.7% were African-American women, 81.9% had low-grade cervical lesions, and all were either uninsured or under insured. Over 95% received follow-up care for an abnormal Pap test within 365 days of referral. When the BCCEDP criteria of follow-up within 60 days were applied, 52.9% were adherent. Rates of self-reported and program documented adherence differed significantly by state. After adjusting for state of residence, women who reported having symptoms of a chronic disease were more likely to be adherent within 365 days (aHR=1.42; 95% CI=1.00, 2.04). Neither age, race, lesion severity, education, number of dependent adults or children, self-perceived physical health, nor smoking status was associated with time to adherence. Findings suggest that institutional factors may be more important than individual factors in predicting time to adherence for an abnormal Pap test.

The SF-36 Among Cambodian and Vietnamese Refugees: An Examination of Psychometric Properties

Among traumatized Cambodian (N=90) and Vietnamese (N=94) refugees attending a psychiatric clinic, the study examined the validity and psychometric properties of the Short Form-36 Health Survey (SF-36), a measure of self-perceived mental and physical health. In both patient samples, all eight SF-36 scales displayed excellent internal consistency (item-scale correlations and Cronbach's α). But, similar to other studies of Asian samples, (a) the Vitality (VT) scale did not separate from the Mental Health (MH) and General Health (GH) scales, as evidenced by item-scale and interscale correlations, and (b) the VT scale loaded as strongly (Vietnamese sample) or more strongly (Cambodian sample) than the MH scale on the so-called Mental Factor in a two-factor solution of the eight scales (with the GH scale also loading heavily on the same factor).

Leisure-Time Physical Activity Among Adults

PURPOSE: This study describes the patterns of leisure-time physical activity among Taiwanese adults and examines factors associated with physical activity in this population. METHODS: We used data from the 2001 National Health Interview Survey of Taiwan (NHIST). NHIST questions on leisure-time physical activity consisted of the type, intensity, frequency and duration of physically active exercises within the past two weeks. A total of 7980 male and 8156 female adults aged 18 years or older who completed the exercise questions were recruited. 'Regularly active' was defined as 5 times a week and accumulated ≥150 minutes in any intensity or 3 times a week for at least 20 minutes in vigorous exercise. RESULTS: Adults in Taiwan were more likely to be 'regularly active' if they were ≥ 45 years of age, graduated from high school or above, non-smokers and without dysfunction in activity of daily living (ADL). Subjects who exercised regularly also had significantly better scores in self-perceived physical function, pain, general health, vitality and mental health (assessed by SF-36 Taiwan version) than those had no exercise (p <0.001). In the multivariate logistic model, independent of age and education status, male subjects had a greater risk of doing no exercise if they were current smokers (OR= 1.83; 95% CI: 1.65, 2.01) and female subjects who had difficulty in ADL were more likely to report no exercise (OR= 1.85; 95% CI: 1.26, 2.71) during their leisure time. CONCLUSION: About half of Taiwanese adults reported no exercise and only one fifth of adults exercised regularly during their leisure time. Physically active exercise was lowest among adults 25–34 years of age, among adults receiving education less than high school, among male smokers and among the disabled females. These RESULTS will inform strategies to promote physical activity among these target groups.

Evaluating the Performance of the Centers for Disease Control and Prevention Core Health-Related Quality of Life Scale with Adolescents

The purpose of this study was to evaluate the performance of the Centers for Disease Control and Prevention's core Health-Related Quality of Life (HRQOL) scale using data from 5,520 public high school students. The 1997 South Carolina Youth Risk Behavior Survey was the source of data. Chi-square analysis was applied to assess scale construct validity. Adjusted multiple logistic regression with selected tobacco and substance use variables was used to assess known-groups validity of the scale's Healthy Days index (items regarding poor physical and mental health days during the past 30 days). Construct validity was supported for the core HRQOL scale by the associations between self-perceived health and physical health, mental health, and activity limitation days. A greater number of poor physical health days, poor mental health days, or activity limitation days was associated with poorer self-perceived health (p<0.0001); however, correlation coefficients for the associations between self-perceived health and physical health days (r=0.24; p<0.001), self-perceived health and mental health days (r=0.26; p<0.0001), and self-perceived health and activity limitation days (r=0.23; p<0.0001), although significant, were low in magnitude. Logistic regression analyses conducted with the Healthy Days index revealed significant (p<0.05) HRQOL differences between users and non- users of tobacco and other substance use variables. As hypothesized, as the usage of each substance increased, reported poor HRQOL days increased, supporting the known- groups validity of the scale. This study provides preliminary evidence that the HRQOL scale items are valid and potentially useful for adolescent surveillance. The results, however, are mixed regarding the inclusion of self-perceived health as a measure of HRQOL for adolescents, given the low correlation coefficients for the associations between self-perceived health and the other HRQOL scale items. These results suggest that adolescents may be rating two separate dimensions of health when rating their self-perceived health and HRQOL. Further research is needed to confirm these findings in different adolescent populations.

Quality of life as medicine: a pilot study of patients with chronic illness and pain.

An intensive 5-day quality-of-life (QoL) session was constructed based on a psychosomatic model. The session was comprised of teaching on philosophy of life, psychotherapy, and body therapy. The three elements were put together in such a way that they mutually supported each other. The synergy attained was considerable. The pilot study demonstrated that in the course of only 1 week, patients had time to revise essential life-denying views and to integrate important, unfinished life events involving negative feelings. Consequently, the patients became more present in the body’s blocked-off areas and subjectively healthier. Nineteen persons with chronic illness and pain (fibromyalgia, chronic tiredness, whiplash, mild depression, and problems involving pain in arms and legs including osteoarthritis), and unemployed for 5–7 years attended the course. In the week before and after the 5-day course, the participants completed the validated SEQOL (Self-Evaluation of Quality of Life Questionnaire) including questions on self-evaluated health and the unvalidated “Self-Evaluation of Working-Life Quality Questionnaire” (SEQWL). This pilot study was without a control group or clinical control. As far as diagnoses were concerned, the group was inhomogeneous. Common for the group was a low QoL, poor quality of working life QWL, and numerous health problems. The study showed an 11.2% improvement in QoL (p < 0.05), a 6.3% improvement in QWL (p < 0.05), and a 12.0% improvement in self-perceived physical health (p = 0.08). There was a 17.3% improvement in self-perceived psychological health (p < 0.05) and satisfaction with health in general improved by 21.4% (p < 0.05). Symptoms like pain were almost halved and several of the participants were free of pain for the first time in years. In conclusion it seemed that the combination of training in philosophy of life, psychotherapy, and body therapy can give patients a large, fast, and efficient improvement in QoL, QWL, and health. It is not known if these changes will be permanent and if all kinds of patients with different health problems will gain from this cure. Further research should be conducted.

Estrés laboral y salud en una muestra de ejecutivos chilenos

Most individual and organizational costs related to job stress are due to preventable health problems. To study the impact of occupational stress in Chile, an instrument that evaluates the different variables involved in the stress process is required. To study the effects of work stressors and psychological variables on health among Chileans managers. To study reliability and validity of the Spanish version of the Occupational Stress Indicator (OSI-2). A translated version of the OSI-2 was applied to a sample of 264 white-collar managers. A high frequency of symptoms was reported by our sample. Back pain was the most frequently reported symptom in managers with high levels of stress. Regression analysis showed that, together, work stressors and psychological characteristics significantly explained self-perceived mental (27.6%) and physical (22.9%) health variance. Responsibilities of the executive role were the stressors most highly associated with poor stress outcomes. The psychological variables most strongly correlated with mental and physical health were Problem-focused Coping and the subscale Impatience of Type A Behavior. The reliability and validity of the OSI-2, Spanish version, were reasonably high. The transactional model of work stress was confirmed in a sample of Chilean managers evaluated with the Spanish version of the OSI-2.

Psychosocial contributors to mental and physical health in patients with systemic lupus erythematosus.

To delineate psychosocial and systemic lupus erythematosus (SLE)-related medical factors that contribute to the mental and physical health of SLE patients. In a cross-sectional study, 44 women completed standardized instruments assessing daily hassles, social support, psychologic distress, and quality of life and underwent a physician examination to assess disease activity and disease damage. Four multiple linear regression analyses were computed to identify factors associated with the following outcomes: patient-perceived psychologic distress and global physical health and physician-assessed disease activity and damage. Variables entered into the regression analyses were: hassles severity, types of social support, SLE disease activity and damage, age, disease duration, education, ethnicity, and global psychologic distress (for the outcomes of self-perceived global physical health and disease activity and damage). The best model explaining global psychologic distress included hassles severity and self-esteem social support. The best model explaining patients' perceptions of their global physical health included hassles severity and tangible social support. Psychologic distress accounted for a significant proportion of variance in both disease activity and damage. High stress (assessed by hassles severity), poor social support, and psychologic distress--potentially modifiable variables--are associated with the mental and physical health of SLE patients.

Women and Injuries–Factors Influencing Recovery

ABSTRACT This study focuses on female patients of working age, hospitalized due to moderate, mostly orthopaedic injuries. The aim was to highlight the medical and non-medical factors affecting outcome. Two groups of women, those who 12 months after the injury reported disability within at least three out of five possible areas (work, family, household, social life and leisure-time; n = 34), were compared with women reporting disability within two areas or less (n = 59). Four factors were predictive of outcome according to the multivariate analysis: injury severity as measured by the Abbreviated Injury Scale (AIS), self-perceived injury-related mental and physical health measured by the Visual Analogue Scale (VAS) during hospitalization and a history of three or more previous injuries requiring medical care. Sociodemographic background factors did not affect the outcome. By integrating information from AIS and VAS with the number of previous injuries, three quarters of the women were correctly classified; i.e., it was possible to detect a majority of those reporting a poorer outcome one year after the injury already during hospitalization. Simple screening instruments like these seem to be useful in the early detection of vulnerable patients. This study further suggests that more attention should be paid to non-medical factors, the importance of which may have been underestimated regarding a poorer outcome among female patients hospitalized due to injuries. Thus, psychosocial support should not only be offered to patients with major trauma or an obvious psychiatric disorder, but to all injured patients and should be considered as an integral part of medical care.

Cultural correlates of self perceived health status among Chinese elderly.

This study examines self-perceived physical and mental health among 213 Chinese elderly who visited the Geriatric Outpatient Clinic of Beijing Hospital, the People's Republic of China. The study hypothesizes that cultural factors, specified by family relations, along with demographic factors, number of diseases, economic well-being, and living conditions have a significant impact on subjects self-perceived health status. Pearson correlation, linear and logistic regression analyses are performed. Results indicate that age, number of diseases, perceived family respect, neighborhood relations, and percentage of income spent on rent are significant predictors of self-perceived physical health. These same factors plus preference to live with a son and personal monthly income are significant predictors of self-perceived mental health. Socio-cultural implications of these findings are examined.

Patient-Based Health Status Measurements in Pediatric Dialysis: Expanding the Assessment of Outcome

Children with end-stage renal disease (ESRD) are now long-term survivors of dialysis and transplantation. To define and provide optimal care for these children, clinicians must assess and appreciate the impact of renal disease and its treatment on their patients' quality of life. The purpose of this pilot project was to examine the correlates of health, family cohesion, and compliance in adolescents with ESRD. Twenty adolescents with ESRD were asked to respond to a generic self-report questionnaire designed to measure self-perceived physical and psychosocial health and family life. A separate, clinician-reported questionnaire was used to assess compliance with the therapeutic regimen. Results indicated that adolescents with ESRD report their general health to be poor. In addition, patients described as less compliant reported poorer health, less family cohesion, and less participation in family activities than their more compliant peers. Although caution must be observed in interpreting our clinical findings, this initial investigation of the health and well-being of an adolescent ESRD population underscores the important relationship between compliance, perceived health status, and family cohesion.

Psychological health, self-reported physical health and health service use

One year after the closure of a furniture factory the health consequences of long-term unemployment were studied among the 215 former employees and an interviewer-administered questionnaire was used to measure psychological health, self-perceived physical health and health service use. Those remaining unemployed 12 months after the closure were found to be 8 times more likely to report poor psychological health than were the re-employed (Odds ratio (OR): 8.5; 95% CI: 4.2-17.0). Self-reported physical ill-health was generally thought be respondents to be due to former work (56 percent of all disorders were related by subjects to former work history) and was also found to be associated with current employment status (OR 5.6; 95% CI: 2.7-11.5). Health services were over-utilized by the unemployed (OR 2.2; 95% CI: 1.2-4.1) and this differential was demonstrated to be even greater for the older and those reporting more diseases. Given the increasing proportion of long term unemployed in many Western countries this health service over-utilization will impose a substantial burden on public health expenditures unless other means of psychological and social support are provided.